The plantar fascia is a structure usually damaged in runners and cyclists, whose main function is the damping and support of the plantar arch. The athlete refers to starting pain on the medial face of the heel, which is directed towards the central part of the fascia and worsens at the end of the day after training, until the time comes when it produces such a functional disability that the athlete cannot carry out their training.
What is
The plantar fascia is a band of dense and fibrous connective tissue, which originates in the posterior face of the limestone tuberosity and extends to the fingers. This plantar aponeurosis is formed by organized fibers longitudinally, divided into three portions: the medial, which is the thickest (approximately 4mm), the side and the central. These fibers of the fascia continue with the Achilles tendon fibers.
What function does it have
The biomechanical functions of the fascia of the foot are:
- Support and keep the plantar arch
- It is a good damping mechanism in the final support phase during the march cycle, under the metatarsal heads
- Makes propulsion forces during the march more effective
- Distribute the weight on the forefoot, among all metatarsal heads
Ethiopathogenesis
Plantar fasciosis is located more frequently in the proximal third, where plantar fascia is inserted. The etiology is multifactorial, highlighting among athletes the following intrinsic factors:
- Valgo Retropié
- Ischiotibial retraction
- Shortening of the hereleo-Trust complex (twins and soleo) plantar
And extrinsic factors:
- Increase of kilometers in training in short periods of time
- Bad choice of shoes
Plantar fasciitis diagnosis
It is very important to make a differential diagnosis with other pathologies that cause similar pains in athletes, such as nerve entrapments, atrophy of plantar fat or calcaneus stress fractures.
To perform the diagnosis, an exhaustive medical history, physical examination and ultrasound study will give us the necessary data to apply the most appropriate treatment to the patient, so that it returns as soon as possible and totally recovered to sports activity.
Prevention
The preventive treatment is always that of first choice, so the guidelines that are indicated below are to be paid, to avoid suffering from a plantar fasciosis:
- Biomechanical study of march
- Ultrasound study in the first symptoms of plantar pathology
- Stretching of all the posterior musculature of the leg after each training
Plantar fasciitis treatment
The treatment of choice depends on the phase in which the fascia is found, which we will see with the ultrasound study.
Initial phase: conservative physiotherapy treatment (ultrasound, low intensity laser, functional bandage etc), NSAIDs (non -steroidal anti -inflammatories), custom plantar orthosis and nocturnal antiequino punch is recommended.
Chronic phase: The treatment must be invasive, with intractical percutaneous electrolysis, corticosteroid infiltration and high molecular hyaluronic acid infiltration.
Readaptation to sport: provided that the athlete goes through an injury and subsequent treatment, he has to re -adapt a sports practice from his physical readceptor, so that the recovery is a total success.
